Kristen PollockMcDonald

Partner

(T) + 1.404.581.8498

Kristen McDonald defends providers in False Claims Act litigation brought by federal and state agencies and qui tam whistleblowers. Her civil fraud experience involves billing, coding, medical necessity, kickbacks, eligibility, potential Stark liability, and documentation errors. Kristen defends providers in government extrapolated audits, and she also conducts internal investigations on behalf of providers and assists providers with repayments and self-disclosures. Additionally, she conducts internal investigations associated with HIPAA/HITECH concerns and defends providers in OCR investigations of potential breaches. She also defends providers in government enforcement actions involving civil money penalties and termination.

In addition, she has extensive experience conducting health care due diligence reviews for mergers, acquisitions, investments, and banking matters, focusing on fraud and abuse and other regulatory and compliance concerns. Kristen routinely advises providers and related investors on fraud and abuse analyses, telemedicine services and reimbursement, and compliance program development and effectiveness reviews, among other legal issues.

Kristen has represented hospitals/health systems; hospice, home health, skilled nursing facilities, and other post-acute care providers; pharmaceutical, medical device, and biologics manufacturers and distributors; telehealth companies; artificial intelligence companies; diagnostic imaging; ambulance suppliers; DMEPOS; financial institutions; and private equity investors.

Kristen is a member of the American Health Lawyers Association and serves as chair of AHLA's Health Care Liability and Litigation Practice Group.

Kristen has written and spoken extensively on health care issues, including risks and liabilities in telemedicine, meaningful use incentive payments and audits, ZPIC audits, government recoveries under the FCA, risk areas for post-acute care providers, and due diligence reviews.

Experience

  • Evidera acquires MedimixJones Day advised Evidera, a business unit of Pharmaceutical Product Development, LLC, in its acquisition of Medimix International, a global technology company providing real-world evidence (RWE) insights and information to the pharmaceutical, diagnostic, and medical device industries.
  • Misonix to acquire Solys Medical, LLCJones Day is advising Misonix, Inc. in its acquisition of Solsys Medical, LLC, a privately held regenerative medical company, in an all-stock transaction valued at approximately $97 million.
  • Large health system advised on regulatory and reimbursement matters for telehealth and telemedicine activitiesJones Day is providing ongoing advice to a large hospital/health system related to telehealth and telemedicine reimbursement and regulatory matters.
  • Private equity backed physician practice undergoes compliance plan effectiveness reviewJones Day assisted a private equity backed physician practice with a compliance plan effectiveness review, including reporting findings and recommendations to management.
  • Leading financial services company provides $125 million secured syndicated credit facility in private equity-backed acquisition of pediatric primary care services providerJones Day represented a leading financial services company, as left lead arranger and administrative agent, in a $125 million senior secured syndicated credit facility, consisting of a $105 million term B loan and a $20 million revolving credit facility, in connection with financing of a private equity-backed acquisition of a pediatric primary care services provider.
  • GE Healthcare collaborates with Preventice Solutions Group to develop ambulatory cardiac arrhythmia monitoring suiteJones Day advised GE Healthcare in its collaboration with Preventice Solutions Group to develop an ambulatory cardiac arrhythmia monitoring suite for diagnostic purposes outside of hospitals or clinics.
  • KeyBank and KeyBanc Capital Markets provide $235 million credit facility to ATI Merger Sub, Avalign Holdings, and Avalign TechnologiesJones Day represented KeyBank National Association as administrative agent, collateral agent, documentation agent, issuing lender, and swing line lender, and KeyBanc Capital Markets Inc., as joint lead arranger and bookrunner, in a $235 million first lien credit facility provided to ATI Merger Sub, Inc., Avalign Holdings, Inc., and Avalign Technologies, Inc. in connection with Linden Capital Partners' acquisition of Avalign Technologies, Inc.
  • Curavi acquires TripleCareJones Day advised University of Pittsburgh Medical Center ("UPMC) and Curavi, in the acquisition by subsidiary Curavi of TripleCare, a Long Island City, New York-based provider of telemedicine solutions for the post-acute, long-term care industry, including skilled nursing facilities.
  • Brockway Moran sells portfolio company MD Now Holdings to Brentwood AssociatesJones Day represented Brockway Moran & Partners, Inc. in connection with the sale of its portfolio company MD Now Holdings, Inc., a large operator of full-service, walk-in urgent care centers, to Brentwood Associates.
  • Cardinal Health sells majority stake in NaviHealth to Clayton, Dubilier & RiceJones Day advised Cardinal Health, Inc. (NYSE: CAH) in the sale of a majority stake in its NaviHealth business to funds managed by Clayton, Dubilier & Rice.
  • ProMedica Health and Welltower complete acquisition of HCR ManorCare and Quality Care properties for $4.4 billionJones Day served as lead antitrust counsel for both ProMedica Health Systems, Inc. and HCR ManorCare, Inc., and co-counsel for ProMedica on other complex corporate, bankruptcy, and regulatory issues, in this first of its kind partnership and acquisition.
  • Physician-owned Ambulatory Surgery Center issued favorable reconsideration decision in Medicare overpayment appealJones Day represented a physician-owned Ambulatory Surgery Center ("ASC") in a recent appeal on claims wherein C2C Innovative Solutions Medical Center, a Medicare contractor, returned a favorable reconsideration decision for the ASC.
  • Staffing company voluntarily dismissed from False Claims Act caseJones Day represented a staffing company in a false claims act case filed in the Eastern District of Texas.
  • Smith & Nephew acquires Rotation Medical Inc. for up to $210 millionJones Day advised Smith & Nephew plc in its acquisition of Rotation Medical Inc., a developer of a novel tissue regeneration technology for shoulder rotator cuff repair, for an initial cash consideration of $125 million and up to $85 million over the next five years, contingent on financial performance.
  • Pediatric Services of America defeats False Claims Act chargesThe U.S. District Court for the Southern District of Georgia granted motions to dismiss drafted by Jones Day, dismissing charges brought under the False Claims Act by whistleblower Tracy Payton against her former employers, Pediatric Service of America, Inc. and Pediatric Home Nursing Services.
  • Cardinal Health acquires rights to Lymphoseek® from Navidea BiopharmaceuticalsJones Day advised Cardinal Health in its acquisition of Navidea Biopharmaceuticals' rights to Lymphoseek® in North America for lymphatic mapping, lymph node biopsy, and the diagnosis of metastatic spread to lymph nodes for the staging of cancer.
  • Revenue cycle management company advised on HIPAA and HITECH regulatory complianceJones Day is providing ongoing HIPAA and HITECH regulatory and compliance advice to a revenue cycle management company.
  • Health care provider defends an Office of Inspector General audit of claimsJones Day is defending a hospice company against an alleged extrapolated overpayment calculated by the Office of Inspector General ("OIG").
  • naviHealth acquires CuraspanJones Day advised naviHealth Inc., a Cardinal Health company, in its acquisition of Curaspan Health Group Inc., a privately held leading provider of care transition tools for hospitals and post-acute healthcare providers.
  • HIPAA Covered Entity investigates possible disclosure of health information to government agencyJones Day assisted a HIPAA Covered Entity in its investigation and analysis of a possible disclosure of health information to the Internal Revenue Service.
  • Additional Publications

    • October 20, 2015
      AseraCare Update: Jury Finds Majority of Sampled Claims False, AseraCare Seeks JMOL Following Phase One of Bifurcated Trial, American Health Lawyers Association Practice Group, Email Alert
    • August 28, 2015
      Fifth Circuit Requires Pharmacies to Arbitrate Claims Against Non-Signatories to Arbitration Agreement, American Health Lawyers Association Practice Group Email Alert
    • December 27, 2013
      Another Record Year for Government Recoveries under the False Claims Act, American Health Lawyers Association Practice Group, Email Alert
    • October 2013
      What Hospitals Need to Know About ZPIC Audits, Healthcare Financial Management Association
    • November 2012
      What do you do when a ZPIC comes knocking? Compliance Today, Health Care Compliance Association
    • August 29, 2012
      Beware of the Minefield - The New Survey and Enforcement Landscape for Home Health Agencies, The American Health Lawyers Association's Healthcare Liability and Litigation Health Briefs
    • February 1, 2012
      The Various Weapons in the ZPIC Arsenal, The American Health Lawyers Association's LTC-SIR Advisor
    • December 22, 2011
      Why the Anti-Kickback Statute May Be the Tip of the Iceberg When It Comes to Questionable Vendor Arrangements, The American Health Lawyers Association's LTC-SIR Advisor
    • May 2011
      Nursing Homes May Find Some Solace Amid the Storm of New Regulations Governing the Assessment of CMPs, American Health Lawyers Association's Healthcare Liability and Litigation Practice Group, May 2011 Health Briefs e-Newsletter
    • June 21, 2010
      Has a Trap Been Set? - What Risks Lie Ahead for Nursing Homes Compelled to Disclose Organizational Information under the Patient Protection and Affordable Care Act, American Health Lawyers Association's Healthcare Liability & Litigation Health Briefs
    • February 17, 2010
      New Guidance on the Indicia of Reliability Standard: What Now Faces Potential Relators in False Claims Act Litigation, American Health Lawyers Association's Healthcare Liability & Litigation Health Briefs

    Speaking Engagements

    • April 15, 2019
      The Evolving Landscape of Telehealth: Politics, Policy, Operations and Oversight, American Telemedicine Association
    • February 24, 2015
      Long Term Care and the Law: Why Long Term Care Providers are Finding New Uses for ADR: Best Practices for an Evolving Landscape, American Health Lawyers Association
    • February 19, 2015
      Due Diligence Reviews in Healthcare Transactions, Jones Day's CLE Academy
    • December 17, 2013
      Advocating Effectively in Health Care Arbitrations, American Health Lawyers Association
    • November 2011
      Beware of the ZPIC - Tips and Tactics from the Trenches, American Health Lawyers Association
    • Fall 2009
      Federal and state efforts to improve patient safety and reduce medical errors, Patient Safety and Never Events
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